EC Dental Science

Aim and Objectives: This study aimed to compare periodontal conditions between smokers and non-smokers, focusing on clinical parameters such as plaque index (PI), probing depth (PD), bleeding on probing (BOP), and clinical attachment loss (CAL), to assess the impact of smoking on periodontal health.

Methodology: A cross-sectional study was conducted involving 200 participants aged 25-40 years, categorized into smokers and non-smokers. Participants with systemic diseases, recent periodontal treatment, or medication influencing periodontal health were excluded. Standardized periodontal examinations were performed using a CPITN probe to measure plaque index (PI), probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL). Statistical analyses were conducted using SPSS software to determine significant differences between groups.

Study Design and Setting: This comparative cross sectional study was conducted at Department of Periodontics from November 2023 - till November 2024.

Results: The findings revealed that smokers exhibited significantly poorer periodontal conditions compared to non-smokers:

• Plaque index (PI): Smokers had higher plaque accumulation (2.8 ± 0.4) compared to non-smokers (1.9 ± 0.3).
• Probing depth (PD): Smokers showed deeper probing depths, particularly in the anterior and premolar teeth, and on palatal and lingual surfaces.
• Bleeding on probing (BOP): Smokers presented higher BOP values (48% ± 5.3) compared to non-smokers (32% ± 4.1).
• Clinical attachment loss (CAL): Smokers exhibited more severe attachment loss, indicating greater periodontal tissue destruction.

Conclusion: Smoking has a detrimental effect on periodontal health, resulting in higher plaque accumulation, deeper probing depths, increased bleeding on probing, and greater clinical attachment loss compared to non-smokers. These findings highlight smoking as a significant risk factor for periodontal disease and emphasize the need for early periodontal intervention and smoking cessation to prevent disease progression.

 Keywords: Smoking; Periodontal Disease; Plaque Index; Probing Depth; Bleeding on Probing; Clinical Attachment Loss

1. World Health Organization. “WHO report on the global tobacco epidemic 2015: raising taxes on tobacco”. World Health Organization (2019).
2. Colombo G., et al. “Pathophysiology of tobacco smoke exposure: recent insights from comparative and redox proteomics”. Mass Spectrometry Reviews3 (2020): 183-218.
3. Reibel J. “Tobacco and oral diseases”. Medical Principles and Practice1 (2003): 22-32.
4. Bernabe E., et al. “GBD 2017 oral disorders collaborators. global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study”. Journal of Dental Research 4 (2021): 362-373.
5. Pindborg JJ. “Tobacco and gingivitis”. Journal of Dental Research3 (2022): 261-264.
6. Leite FR., et al. “Effect of smoking on periodontitis: a systematic review and meta-regression”. American Journal of Preventive Medicine6 (2018): 831-841.
7. Helal O., et al. “Predictors for tooth loss in periodontitis patients: Systematic review and meta‐analysis”. Journal of Clinical Periodontology7 (2019): 699-712.
8. Papapanou PN., et al. “Periodontitis: Consensus report of workgroup 2 of the 2019 world workshop on the classification of periodontal and peri‐implant diseases and conditions”. Journal of Periodontology1 (2018): S173-S182.
9. Wu J and Sin DD. “Improved patient outcome with smoking cessation: when is it too late?”. International Journal of Chronic Obstructive Pulmonary Disease 6 (2011): 259-267.
10. US Department of Health and Human Services. Smoking cessation: a report of the Surgeon General.
11. Jha P and Peto R. “Global effects of smoking, of quitting, and of taxing tobacco”. New England Journal of Medicine1 (2019): 60-68.
12. Japuntich SJ., et al. “Smoker characteristics and smoking-cessation milestones”. American Journal of Preventive Medicine 3 (2011): 286-294.
13. Torrungruang K., et al. “The effect of cigarette smoking on the severity of periodontal disease among older Thai adults”. Journal of Periodontology4 (2005): 566-572.
14. Thomson WM., et al. “Cigarette smoking and periodontal disease among 32‐year‐olds: a prospective study of a representative birth cohort”. Journal of Clinical Periodontology10 (2007): 828-834.
15. Thomson WM., et al. “Cigarette smoking and periodontal disease among 32‐year‐olds: a prospective study of a representative birth cohort”. Journal of Clinical Periodontology10 (2007): 828-834.
16. Arora M., et al. “Cigarette smoking and tooth loss in a cohort of older Australians”. The Journal of the American Dental Association10 (2010): 1242-1249.
17. Huang C and Shi G. “Smoking and microbiome in oral, airway, gut and some systemic diseases”. Journal of Translational Medicine 1 (2019): 225.
18. Jang AY., et al. “Association between smoking and periodontal disease in Korean adults: the fifth Korea National Health and Nutrition Examination Survey (2010 and 2012)”. Korean Journal of Family Medicine2 (2016): 117.
19. ALHarthi SS., et al. “Association between time since quitting smoking and periodontitis in former smokers in the National Health and Nutrition Examination Surveys (NHANES) 2009 to 2012”. Journal of Periodontology 1 (2021): 16-25.
20. Fiorini T., et al. “Is there a positive effect of smoking cessation on periodontal health? A systematic review”. Journal of Periodontology1 (2014): 83-91.
21. Chambrone L., et al. “Effects of smoking cessation on the outcomes of non‐surgical periodontal therapy: a systematic review and individual patient data meta‐analysis”. Journal of Clinical Periodontology6 (2013): 607-615.
22. Terrades M., et al. “Patients' knowledge and views about the effects of smoking on their mouths and the involvement of their dentists in smoking cessation activities”. British Dental Journal11 (2009): E22.
23. Yang I., et al. “Oral microbiome of electronic cigarette users: A cross‐sectional exploration”. Oral Diseases4 (2023): 1875-1884.
24. Bhandari A and Bhatta N. “Tobacco and its relationship with oral health”. JNMA: Journal of the Nepal Medical Association243 (2022): 1204-1206.
25. Scribante A., et al. “Ozonized gels vs chlorhexidine in non‐surgical periodontal treatment: a randomized clinical trial”. Oral Diseases6 (2024): 3993-4000.